Independence Coaching, L.l.c.

NPI #1073726162 in Phoenix, Arizona

Provider Information

NPI Number: 1073726162
Entity Type: Organization
Organization Name: Independence Coaching, L.l.c.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 7, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1345 E BUTLER DR
City: Phoenix
State: Arizona
ZIP Code: 85020-3824
Phone: (602) 524-0583

Authorized Official

Name: MR. VERN JOHNSON, BSW
Title: PRESIDENT
Phone: (602) 524-0583

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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